Monkeypox and India’s to-do list

The declaration of monkeypox as a global health emergency by the World Health Organization (WHO) over the weekend has created what can only be termed a stir (some-thing shocking that captures the public’s imagin-ation, according to the dictionary). A stir would rank several notches above awareness on the concern scale, and perhaps a few notches below full-blown panic. The WHO was right to declare the global health emergency. This is the seventh time since 2009 that it is declaring one such (zika, ebola, polio, swine flu, and Covid-19 are among the other diseases that caused the declaration of similar emergencies). It is the WHO’s job to declare such emergencies, ensuring a balance between caution and panic, and, after the criticism it has come under for its early handling of Covid-19, the WHO cannot be blamed for being proactive.

There have been around 16,000 cases of monkeypox (and five deaths), but across 75 countries, showi-ng that this is a disease that is spreading (and whose numbers will continue to rise). The number of cases in India will increase too. Monkeypox is transmitted through close and prolonged contact with an infectious person, fomites (including soiled sheets), and, rarely, respiratory droplets. But infected people are all symptomatic, which should make it possible for them to be identified and quarantined.

So, what should India do? Our experience with Covid-19 and early missteps provide some answers, although it is unlikely that monkeypox will become a pandemic. One, India should put a testing regimen in place. This is easier said than done because monkey-pox requires laboratory testing. Over the past few months, some rapid testing kits have found their way to the market, and the health ministry should evalu-ate them, and buy them. Two, given that the small pox vaccine is considered to be effective against monkeypox — India stopped its smallpox vaccinations in the early 1980s, which means around 70% of its population hasn’t received these — the ministry should work with local manufacturers to restart production of the vaccine (how soon? Well, this should have been done by now), and stock adequate quantities. Three, given that cases will increase (albeit at a much slower pace than seen in the case of Covid-19), India should put in place a protocol that involves hard quarantine for the infected, aggressive contact-tracing, and perhaps even precautionary ring vaccination of direct contacts (which is beginning to find favour among many experts). There’s no need for panic, but the health minister would do well to have these three items on his to-do list for this week.